28 February 2013 Cortical thickness estimation of the proximal femur from multi-view dual-energy X-ray absorptiometry (DXA)
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Proceedings Volume 8670, Medical Imaging 2013: Computer-Aided Diagnosis; 86700B (2013) https://doi.org/10.1117/12.2006389
Event: SPIE Medical Imaging, 2013, Lake Buena Vista (Orlando Area), Florida, United States
Hip fracture is the leading cause of acute orthopaedic hospital admission amongst the elderly, with around a third of patients not surviving one year post-fracture. Although various preventative therapies are available, patient selection is difficult. The current state-of-the-art risk assessment tool (FRAX) ignores focal structural defects, such as cortical bone thinning, a critical component in characterizing hip fragility. Cortical thickness can be measured using CT, but this is expensive and involves a significant radiation dose. Instead, Dual-Energy X-ray Absorptiometry (DXA) is currently the preferred imaging modality for assessing hip fracture risk and is used routinely in clinical practice. Our ambition is to develop a tool to measure cortical thickness using multi-view DXA instead of CT. In this initial study, we work with digitally reconstructed radiographs (DRRs) derived from CT data as a surrogate for DXA scans: this enables us to compare directly the thickness estimates with the gold standard CT results. Our approach involves a model-based femoral shape reconstruction followed by a data-driven algorithm to extract numerous cortical thickness point estimates. In a series of experiments on the shaft and trochanteric regions of 48 proximal femurs, we validated our algorithm and established its performance limits using 20 views in the range 0°–171°: estimation errors were 0:19 ± 0:53mm (mean +/- one standard deviation). In a more clinically viable protocol using four views in the range 0°–51°, where no other bony structures obstruct the projection of the femur, measurement errors were −0:07 ± 0:79 mm.
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N. Tsaousis, N. Tsaousis, A. H. Gee, A. H. Gee, G. M. Treece, G. M. Treece, K.E.S. Poole, K.E.S. Poole, } "Cortical thickness estimation of the proximal femur from multi-view dual-energy X-ray absorptiometry (DXA)", Proc. SPIE 8670, Medical Imaging 2013: Computer-Aided Diagnosis, 86700B (28 February 2013); doi: 10.1117/12.2006389; https://doi.org/10.1117/12.2006389

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